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This paper reports on a systematic review of the published literature on the effectiveness of whole‐school behavioural interventions, which aim to promote emotional and social well‐being among young people in secondary education. The findings are based on 27 studies of varying designs with some limitations. The results suggest that the literature is not well developed, and has a substantial skew towards interventions conducted in the United States. However, it does suggest that conflict resolution training is successful in promoting pro‐social behaviours in the short term, and that the use of peer mediators may be effective for longer‐term outcomes. The evidence relating to preventing bullying and disruptive behaviour is more varied, with evidence of mixed effectiveness being identified for the roles of the community, teachers, young people, external agencies and parents.

A systematic review of effects and mediators was conducted to determine whether school health promotion interventions (SHPIs) can enhance children's academic performance (AP).

PubMed and PsycINFO database searches and subsequent reference list reviews were conducted for papers published before 18 January 2012 with a standard form of eligibility criteria encompassing standardized measures of AP (e.g. grade‐point averages, end of year marks) and methodology sound studies (e.g. randomized controlled trials, cross‐over controlled trials, quasi‐experimental designs with pre‐ and posttest) of interventions addressing healthy lifestyles in the general school population. Information for the study description was extracted from the original article (e.g. country, study purpose, research design, effects on AP measures, components of Health Promoting School, author's explanations for observed effects). Effect sizes were calculated for effects on AP measures.

Remaining SHPIs targeted exclusively the maintenance of energy balance (physical activity (PA) and nutrition) and had small to large positive effects on AP; no negative effects were reported. Effects of different kinds of interventions varied across academic domains. One PA intervention reported large effects of vigorous activity on mathematics; another PA intervention had small to medium impact on language scores. Small to medium effects were found for interventions combining nutrition and PA elements; one affected mathematics and another both mathematics and language scores. Slight improvements in language scores were observed for breakfast provision in schools.

The small number of interventions, little homogeneity in intervention components (content, length and measurement instruments), reporting bias and some inconsistent results should be considered when interpreting our results. Our review did not allow definite conclusions concerning mechanisms responsible for effects of SHPIs on AP.

Planned development of school health promotion will need to be based on evidence. Measures of AP should be included in evaluations of SHPIs. Schools and health professionals should be made aware of the importance of these measures.

We provide evidence that SHPIs promoting energy balance can affect AP, also if they do not target children at risk or with specific symptoms, nor employ elements directly connected to school education.

This study assessed the effectiveness of malaria classroom corner (MCC), school-based intervention in the promotion of basic malaria awareness and common control practices among children of primary school age.

A quasi-experimental design was employed, involving 206 children of primary 5 and 6 classes from two randomly selected public primary schools in Owerri, South Eastern Nigeria. The MCC was designed and set up in the intervention school (with 103 children) while the control school (with 103 children) was offered malaria health talk. Structured pre-tested questionnaire was used to collect data pre- and post-intervention in both schools. Data was analysed using Statistical Package – Stata version 14.1 (Stata Corp, College Station, TX, USA).

Results show that there was a significant enhancement of basic malaria awareness (p = 0.0003) and common preventive and management practices (p = 0.0202) among children in the intervention primary school compared to those in the control primary school.

The study did not account for actual behaviour change, as its scope was within basic malaria awareness and common control practices.

This approach could enhance awareness and proactiveness of school children towards malaria prevention and overall health consciousness.

This could help in achieving a healthy population of school children with a positive effect on their school performance.

The MCC could provide a simple, participatory and effective approach for the promotion of basic malaria awareness and common control practices among primary school-age children in malaria endemic areas. Such children could, in turn, become malaria conversation drivers and behaviour change agents in their homes and communities, thereby contributing to the malaria elimination efforts.

Obesity in children and adolescents is a significant public health concern. The World Health Organization Health Promoting Schools (HPS) framework promotes good nutrition and physical activity in school settings. While HPS is embraced globally, effective implementation and sustainable programmes are a continued challenge. This paper aims to report on the characteristics of current school interventions based on HPS and implementation barriers and enablers.

A literature search identified peer-reviewed studies of school health interventions reflective of the HPS framework focusing on obesity prevention. Studies from all countries were included, if conducted in primary and/or secondary schools; included a sufficient amount of qualitative implementation or process evaluation data to draw conclusions regarding key barriers and enablers to implementation; and were published in English.

Nine interventions (n = 9) from seven countries were included. Most were implemented in primary schools and focused on specific grade levels. Engaging parents, the home environment, teacher time constraints, fun interventions, student participation, teacher training, integration with the curriculum and stakeholder engagement all emerged as strong implementation themes. Teachers as role models, establishing community partnerships and policy support also emerged as common themes.

Future interventions may benefit from enhancing teacher and parent health promotion. Partnerships with initiatives focusing on environmental sustainability may simultaneously benefit human and planetary health while strengthening stakeholder engagement opportunities and consistent messaging throughout the community. More comprehensive evaluation data are needed, in particular, for long-term HPS initiatives.

Aims to assess the effectiveness of a child‐to‐child approach to promote healthier snacking in primary school children. A total of 55 schools in North and West Belfast were matched for socio‐economic status (SES). Ten schools were randomly selected and allocated into intervention and control groups. A total of 482 children took part. Older intervention children were given the “snacks facts” programme and became “teachers” in the child‐to‐child intervention. All children had baseline and final assessments made of their dental health knowledge (older children only), snacking knowledge and behaviours using questionnaires and rubbish bags. Older intervention children had greater increases in their mean knowledge scores compared with control children. Older intervention children had greater decreases in mean cariogenic snacking scores compared with control children. Younger children attending higher SES schools had significant decrease in mean cariogenic snacking score compared with children attending lower SES schools. Concludes that the child‐to‐child approach provided an avenue by which children improved their dental health knowledge and modified their snacking habits during break‐time at school.

This paper evaluates the implementation of a school-based physical activity intervention and discusses how the intervention outcomes can be influenced by the implementation.

In four of the nine lower secondary schools in which the intervention was conducted, the authors examined implementation fidelity, adaptation, quality, responsiveness and dose received. The authors conducted focus group interviews with teachers (n = 8) and students (n = 46) and made observations. Dose delivered was examined quantitatively, with weekly registrations.

Results showed that two out of four schools made few and positive adaptations, implemented the intervention with high fidelity and quality and responded positively. Four main factors were found to influence implementation: frame factors, intervention characteristics, participant characteristics and provider characteristics.

A cross-sectional design was used and may not represent implementation throughout the whole school year.

In terms of large-scale implementation, the intervention may be generalizable. However, intervention criteria such as adequate facilities and a flexible timetable may be unattainable for some schools. The intervention can be adapted without compromising its purpose, but adaptations should be a result of cooperation between students and teachers.

Process evaluations on this topic are rare. This study adds to a limited knowledge base concerning what factors may influence implementation of school-based physical activity interventions for adolescents.

This paper aims to present the process evaluation for a two‐year (2008‐2010) participatory action research project focusing on home‐school partnership in health learning, undertaken within the Schools for Health in Europe (SHE) in Eastern Finland.

Two intervention schools and two control schools (grade 5 pupils, parents, and selected school personnel) participated in a study. Process evaluation data were collected from intervention schools after 10 months of participation, by interviewing two classroom teachers and three families. In addition, program documents and relevant statistics were collected from schools during the intervention.

Teachers' opinions on the development process varied from more concrete expectations (School A teacher) to overall satisfaction to implementation (School B teacher). Parents believed that their children would benefit from the project later in life. The context and differences of the school environments were likely to affect the development process at the school level.

This paper demonstrates a process evaluation in two schools and, therefore, limits the generalizability of the findings.

The process evaluation was an essential part of this intervention study and may provide a useful structure and an example for process evaluation for future school‐based health intervention studies.

This study highlights the importance of planning the process evaluation structure before the start of the intervention, brings out the relevance of systematically assessing the process while it is ongoing, and illustrates process evaluation in an action research project.

Reviews previous studies of the universal approach to mental health promotion, and disease prevention programmes or interventions in schools. Over 8,000 publications were identified initially and 425 studies obtained for further review. The inclusion criteria were met by 17 (mostly US) studies investigating 16 interventions. Positive evidence of effectiveness was obtained for programmes that adopted a whole‐school approach, were implemented continuously for more than a year, and were aimed at the promotion of mental health as opposed to the prevention of mental illness. Provides evidence that universal school mental health promotion programmes can be effective and suggests that long‐term interventions promoting the positive mental health of all pupils and involving changes to the school climate are likely to be more successful than brief class‐based mental illness prevention programmes.

Involvement of parents/carers may increase effectiveness of primary school-based alcohol-misuse prevention projects through strengthening family-based protective factors, but rates of parental engagement are typically low. This paper reports findings from an exploratory trial of a school-based prevention intervention – Kids, Adults Together (KAT), based on the Social Development Model, which aimed to promote pro-social family communication in order to prevent alcohol misuse, and incorporated strategies to engage parents/carers. The purpose of this paper is to assess the feasibility and value of conducting an effectiveness trial of KAT.

The study was a parallel-group cluster randomised exploratory trial with an embedded process evaluation. The study took place in south Wales, UK, and involved nine primary schools, 367 pupils in Years 5/6 (aged 9-11 years) and their parents/carers and teachers. Questionnaires were completed by pupils at baseline and four month follow-up, and by parents at six month follow-up.

Overall KAT was delivered with good fidelity, but two of five intervention schools withdrew from the study without completing implementation. In total, 50 per cent of eligible parents participated in the intervention, and KAT had good acceptability among pupils, parents and teachers. However, a number of “progression to effectiveness trial” criteria were not met. Intermediate outcomes on family communication (hypothesised to prevent alcohol misuse) showed insufficient evidence of an intervention effect. Difficulties were encountered in identifying age appropriate outcome measures for primary school-age children, particularly in relation to family communication processes. The study was unable to find comprehensive methodological guidance on exploratory trials.

It would not be appropriate to conduct an effectiveness trial as key progression criteria relating to intervention and trial feasibility were not met. There is a need for new measures of family communication which are suitable for primary school-age children, and more guidance on the design and conduct of exploratory/feasibility trials.

KAT achieved high rates of parental involvement, and its theoretical framework and processes could be adapted by other interventions which experience difficulties with recruitment of parents/carers.

In school improvement studies, randomized experiments are rare. A special problem is the assignment to the experimental and control groups, taking into account the different starting conditions at the schools in terms of school improvement competencies. The purpose of this paper is to take the example of an intervention study conducted in Baden-Württemberg, Germany, the extent to which the challenges involved with a quasi-experimental design were addressed is examined.

The intervention study was conducted with 54 math teachers (experimental group: n=29; control group: n=25) and their grade 7 and 8 classes (n=1,054) at 13 secondary schools. It aimed to increase teacher cooperation on teaching for promotion of students’ self-regulated learning. T-tests, Mann-Whitney tests, ANOVA, multilevel regression analyses were conducted.

At the beginning of the intervention, the teachers in the two groups did not differ significantly in prior cooperation on teaching processes and in attitudes toward cooperation. However, they differed in prior cooperation on school framework conditions and teaching processes. The intervention was effective in increasing teachers’ cooperation intensity on instruction, and teachers’ attitude toward binding cooperation. However, teaching processes did not change depending on experimental or control group.

Teacher cooperation practice was assessed only by teachers’ self-report. No indicators on the quality of the cooperation among teachers were included.

The paper discusses the challenges and limitations of conducting intervention studies on school improvement. Implications for further research are given.

This paper fulfils an identified need to study how quasi-experimental designs can be implemented in intervention studies on school improvement.